Summary:

Dr. Alvord was born to a Navajo father and a Caucasian mother--bilagaana--and felt from the beginning that she was walking the path between two worlds. Her childhood was spent on an Indian reservation and she was very close to her Indian grandmother.

She was fortunate to be able to attend Dartmouth College where there is strong support for American Indians. Actually there were 50 other Indian students there when she enrolled. From there she went to Stanford University for medical school and a surgical residency. This was a very unusual path for an Indian woman.

While in medical school and residency she felt very much separated from her Indian heritage and was glad to start her practice of surgery in the Indian Health Service and eventually to return to the Indian Hospital at Gallup, New Mexico, just fifty miles from the reservation where she grew up. This gave her the opportunity to learn more about Indian medicine and how to care for Indian patients.

While there she met her husband, a considerably younger Caucasian, and had her first child after a problem pregnancy. She sought the help of an Indian Medicine Man during this experience and felt much help from him. This is described very vividly.

Just eighteen years after she left Dartmouth she returned to be the Associate Dean for Minority and Student Affairs and to practice surgery and teach part time. There she hopes to share the Navajo philosophy of a balanced and harmonious life called "Walking in Beauty."

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This haunting memoir by a South African surgeon who has witnessed tremendous suffering across the globe is best read as his story, and not a war chronicle as the subtitle would suggest, since large chunks of the book are not about war in the dressing station sense of the term. That said, however, the war that rages inside the author continues throughout the book and gives the reader glimpses of wisdom gained during Kaplan's remarkable journey of life amidst death. The book is culled from journals of writing and sketches that he kept throughout his travels.

Kaplan's first crisis occurs when he joins fellow medical students in an anti-apartheid demonstration in Cape Town and, following the lead of a more senior student, Stefan, tends to the wounded and frightened after riot police attacked the demonstrators. Kaplan then gets the call of not only medicine as service, but surgery as service, when, as a neophyte doctor, he saves the life of a youth shot in the liver by the police.

This feat should not be underestimated, though the author writes with humility. Indeed, in recounting later incidents in which patients die, the odds tremendously stacked against the patients surviving anyway (a woman with disseminated intravascular coagulopathy and multiple organ failure, or the Kurdish boy in a refugee camp with a great hemorrhaging, septic wound), the author's self-chastisement is a painful reminder of how the physician suffers with each loss.

After a beautifully written prologue which begins, "I am a surgeon, some of the time" (p. 1), the book proceeds chronologically, each chapter named for the location of the action. Kaplan leaves South Africa to avoid military service and the fate that befell Stefan, who becomes an opioid addict after euthanizing a torture victim in a horrible scene of police brutality and violence. Kaplan's post-graduate training in England and BTA (Been to America) research stint heighten his sense of cynicism about hierarchy in English society and capitalistic forces in American medical research.

Ever the outsider, Kaplan first returns to Africa (treating victims of poverty, deprivation and violence), then sets off to war zones in Kurdistan, Mozambique, Burma (Myanmar), and Eritrea. In between, he works not only as a surgeon, but also a documentary filmmaker and a cruise ship and flight doctor. He avoids the more established medical humanitarian relief efforts, such as Médecins Sans Frontières, and instead prefers to work where no other ex-pat physician will go--enemy territory, front lines, and poorly equipped dressing stations.

Along the way he decides the number of people he has helped as a surgeon, particularly in Kurdistan, has been small compared to the potential to intervene in broader public health measures (he meets a Swiss water treatment engineer) and occupational health exposés to help abused victims (e.g., of mercury poisoning in South Africa and Brazil). The book ends with Kaplan studying to become an expert in occupational medicine, though, incongruously, in the heart of London's financial district where he treats stress-related illness.

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Brown, anthropologist and Professor of Anthropology of Religion at Drew University, describes the life, religion and healing practices of Marie Therese Alourdes Macena Margaux Kowalski, also known as Alourdes or Moma Lola, a priestess of Voodou, who emigrated to the U.S. from Port-au-Prince in Haiti at the age of 24. What began as an ethnographic research project on immigrant Haitians, turned into a deep personal friendship between Moma Lola and Brown, and a privileged look at the practices and patients of a priestess, and at the socio-cultural lifeworlds of the Haitian community in Brooklyn and in Haiti between 1978 and 1986.

The book presents an intimate description of an alternative healing tradition through a number of perspectives. Brown alternates between a personal, an analytical, and a descriptive narrative of Moma Lola’s own history and her encounters with patients. In some chapters, Brown fictionally reconstructs the patient’s stories, so that the book is part traditional ethnography, and part fiction.

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In the book’s Introduction, Dr. Cleaveland explains his personal need for real and fictional heroes. Seeing himself often as a victim of cruel childhood peers, he sought protectors and savored particularly the exploits of World War II heroes. His heroes, he notes, delivered him safely through childhood and adolescence.

Cleaveland describes seeing a documentary movie about Dr. Croydon Wassel in 1944; Dr. Wassel became his first personal hero. A book about Dr. Wassel was read by Cleaveland many times; later, as an adult, Cleaveland looked for the book again and set out to ascertain its authenticity. From extensive research he found Dr. Wassel to be far more courageous than he had anticipated--"studied, found not wanting."

The author was introduced to the story of Dr. Billie Dyer in 1992 through a collection of short stories. Dyer was a black physician who kept a diary during his eighteen months in service in the U.S. Medical Corp during the First World War. Cleaveland found a copy of the diary in the public library in Lincoln, Illinois and learned more about a new hero.

Other heroes he writes about were Dr. Woodrow Dodson, who served sixty years as a "domestic medical missionary"; and Dr. Lonnie Boaz, a black physician, the son of a victim of a hate crime, who became a well known ophthalmologist, husband, father, civic leader, and reformer after starting out as a painter, janitor, and army medic.

Cleaveland considers some of his patients to be heroes: Vera Gustafson, a World War II nurse whom he interviewed extensively, later adding historical information to her story; Paulette McGill, a childhood diabetic cared for by Dr. Cleaveland for twenty years; and an obese diabetic who became a "universal friend," teaching others about devotion and courage. Other patients were also deemed heroic, each for some special reason.

The longest story, saved till the last, is about Dr. Janusz Korczak, described by Dr. Cleaveland as the most heroic figure he knows of. Korczak was a Polish, Jewish pediatrician who devoted his life to improving the welfare of children in the Warsaw ghetto; he was deported to the Treblinka concentration camp with the children. (A movie that came out in 1990 dramatically tells this story.)

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Nisbett, a professor of psychology at the University of Michigan, argues that thinking is not universally the same, in time or around the globe. Specifically, Asians and Westerners vary in what they perceive, how they process it, and what action they might take. Nisbett has studied seminal figures such as Aristotle and Confucius, the geographical and social origins of Greece and China, and clues from the languages involved.

He explains a series of polarities, which can be quickly sketched (Eastern first/then Western): relationships/action, choice; feelings/logic; interdependence/independence; circularity, cycles/linearity; field dependence/divisible categories; harmony/debate; ground/figure; context/focal object; setting/outcome; and multiple causes/single cause and effect. Nisbett has also conducted experiments with students of Eastern and Western backgrounds to demonstrate that such differences are still real.

Finally, he argues that, with globalization, the two traditions will merge.

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A severe synopsis of Foucault's first major work might show how Foucault charts the journey of the mad from liberty and discourse to confinement and silence and how this is signposted by the exercise of power. He starts in the epoch when madness was an "undifferentiated experience" (ix), a time when the mad roamed the countryside in "an easy wandering existence" (8); Foucault shows the historical and cultural developments that lead to "that other form of madness, by which men, in an act of sovereign reason, confine their neighbors" (ix), challenging the optimism of William Tuke and Phillipe Pinel's "liberation" of the mad and problematizing the genesis of psychiatry, a "monologue of reason about madness" (xi).

Central to this is the notion of confinement as a meaningful exercise. Foucault's history explains how the mad came first to be confined; how they became identified as confined due to moral and economic factors that determined those who ought to be confined; how they became perceived as dangerous through their confinement, partly by way of atavistic identification with the lepers whose place they had come to occupy; how they were "liberated" by Pinel and Tuke, but in their liberation remained confined, both physically in asylums and in the designation of being mad; and how this confinement subsequently became enacted in the figure of the psychiatrist, whose practice is "a certain moral tactic contemporary with the end of the eighteenth century, preserved in the rites of the asylum life, and overlaid by the myths of positivism." Science and medicine, notably, come in at the later stages, as practices "elaborated once this division" between the mad and the sane has been made (ix).

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Gilbert begins her narrative with the event that inspired her to write: her husband's death in 1991 after a routine prostatectomy. "Though he was in robust health apart from the tumor for which he was being treated, Elliot died some six hours after my children and I were told that his surgeon had successfully removed the malignancy. And for the first six months after he died, death suddenly seemed plausible ... "(1).

But whereas her book Wrongful Death (annotated in this database) deals with Elliot Gilbert's death, the present work takes the author through death's door into personal reflection and research across a vast area, including personal, cultural, and literary aspects of death. Larger than a memoir, her work universalizes her personal experience with dying and death. And writing is what she does and what she has to do: "THIS is the curse. Write" (92).

Gilbert divides her material into three main sections, each containing several subsections: 1. Arranging my mourning: five meditations on the psychology of grief; 2. History makes death: how the twentieth century reshaped dying and mourning; and 3. The handbook of heartbreak: contemporary elegy and lamentation. The 27 illustrations she has selected range from the Isenheim Altarpiece by Matthias Grünewald to recent photographs by Dan Jury, to Maya Lin's Vietnam War Memorial. In these symbolic representations, Gilbert finds our universal fear of the process of dying, "If this is what it is, GrŸnewald seems to be telling the viewer, for Our Lord to die the death, what must it be for those of us less staunch, less noble - in short, less divine?" (115).

Traditional elegy, by John Milton and Percy Bysshe Shelley, on the other hand, seeks to comfort the poet and reader with the hope of a life hereafter, but modern secular poets like William Carlos Williams and Samuel Beckett offer no solace at all. The older term "expiration" gives hope that our spirit may survive our death. But "termination," the twentieth-century word for death, describes how humans and animals die, in our post-Darwinian world. Her word for this is nada. The holocaust stands as the ultimate ex-termination, or death by technology.

Seeking to understand Sylvia Plath's disease- and death-filled poetry, Gilbert travels literally to Berck-Plage, France, and figuratively, through the notorious "Daddy," "Lady Lazarus," and "Getting There." As a woman and a writer, Gilbert is fascinated by Plath: "For perhaps more than anyone else - more even than her much-admired Wallace Stevens himself - she really did articulate not just the vision but the 'mythology of modern death' that Stevens tentatively proposed" (310). The author contrasts Plath with nineteenth-century Walt Whitman who said, "... to die is different from what anyone supposed, and luckier" (332). Whitman seems to be ambivalent or even positive towards death; Emily Dickinson, of his same century, finds death terrifying.

Ultimately, modern death is embarrassing; death avoidance prevails, notably among doctors. This despite the fact that the first patient a medical student sees is a cadaver. Death is a doctor's failure and it is easier to blame the patient than to accept the death. Death in an American hospital is a "humanectomy", or physical removal of the individual's humanity as she/he is attached to IVs, monitors, feedings tubes, and other mechanical devices.

Modern hospital death is demeaning, because patients are granted little privacy, their TV sets are set to blaring; all personnel, including doctors, enter their rooms unannounced: "Whereas the patient is emotional - fearful, angry, needy - the doctor is detached, abstract, 'objective' " (189). Clearly, the author still lovingly mourns her dead husband bleeding to death alone in a hospital room. Energized by lost love, she writes and documents and works her way toward death.

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The description on the cover of this collection of essays states that it is "candid firsthand accounts of the profound experiences that transform medical students into doctors". It is edited by a woman breast surgeon (Susan Pories) who teaches students in the Harvard Medical School Patient-Doctor Course; a MD/MBA candidate (Sachin Jain) who anticipates a career as a clinician , scholar and activist; and a psychiatrist (Gordon Harper) who is director of the Patient-Doctor III course at Harvard. The short forward is by physician-writer Jerome Groopman. The 44 essays are divided into sections by theme: Communication, Empathy, Easing Suffering and Loss, and Finding a Better Way. I found it helpful to read the short biographies of each student in the back of the book, before reading that student's essay.

The diversity of the essayists is very wide which makes for a broad look at many important issues. There are several subjects that we tend to avoid (student response to the nude body, the presence of students when end of life decisions are being made, the tensions between caring for a patient and having to do something which causes pain, trying to think of patients a people as well as complex biomedical problems). One of the editors wishes that the book will help people understand the working of the hospital and the many ways in which new doctors learn. The book is certainly a personal look at the teaching hospital from the students' view.

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This erudite collection of twelve essays by a physician-scientist weaves allegory, myth, clinical experience, science, and western history and religion (particularly Catholicism) with ruminations on the meaning of medicine and health. The author is the chair of the Department of Medicine at Jagiellonian University School of Medicine in Cracow, Poland – a university founded in 1364 and which counts Copernicus and Pope John Paul II as alumni. Hence it is with this sense of history that the author addresses such topics as cardiology, pain and its relief, genomics, critical care, infectious disease, health care financing. For instance, in Chapter VII “A Purifying Power” Szczeklik traces the word “katharsis” (the title of the book in the original Polish) to the Greek chorus, Pythagoras and Aristotle, then explores the interplay between music and medicine.

Some of the memorable clinical tales are of the reanimation of a frozen man and the resuscitation of a man who drags himself to the newly opened critical care unit and then very cooperatively codes. The narratives about research, such as the self-experimentation with prostacyclin just after its discovery in the 1970s, are also riveting.

The scope includes the realms of science and religion. For instance, Szczeklik mentions both the Papal Academy of Sciences session on evolution (Pope John Paul II: “The scientific theory of evolution is not at odds with any truth of the Christian faith.” p. 128) as well as religious overtones to metaphoric declarations about the power of the genome (“the language of God” p. 125).

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Having remarried after a long and partly happy life with a woman who bore him three sons, novelist Campbell Armstrong lives in rural Ireland with his second wife. He learns that his first wife, who works in Phoenix, has advanced lung cancer and, with his second wife’s blessing, goes to spend time with her and their grown sons. In the course of that trip, he reflects on their life together, their romance, his alcoholism and its effect on their family, their move to the U.S., their losses, and the remarkably enduring affection between them and, surprisingly, between the first wife and the second.

Completely surprising all of them, a daughter his first wife gave up for adoption, who has searched for years for her birth mother, shows up in the months before Eileen’s death and makes the trip to Phoenix to meet her birth mother. Her appearance turns out to be a gift to the whole family. She assuages decades of sorrow and longing in both her and her mother’s hearts. She herself has cancer, not as advanced as her mothers. Both she and her mother work in health care professions. Much psychological and spiritual healing is accomplished between them in the short time they have before Eileen’s death several months later.

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